The Recession’s ‘Silent Mental Health Epidemic’
Life + Money

The Recession’s ‘Silent Mental Health Epidemic’


Mark Altbier hasn’t slept through the night once since the printing company that employed him for 18 years announced early last spring it would be shuttering its plant in May.  Now, six months later, Altbier, 62, continues to look for work at a printing company but accepts that he may never find another  job again in that industry.  “I can’t change the 40 years that happened.  Printing’s what I know,” Altbier explained in a recent interview.  “But I also realize now that it’s a reality that no matter what I do, I won’t have what I had before and will have to take a tremendous pay cut if I’m lucky enough to get any job, and that’s depressing….I’ve never felt that way before.” 

As President Obama and Republican leaders argue over the best way to reduce  9.1 percent unemployment and revive a near-flat-lining economy, little attention has been paid to the widespread emotional and psychological damage caused by long-term unemployment – and the consequential drain  it is having  on government resources and workforce productivity.

With an estimated three-quarters of the 14 million unemployed Americans out of work for more than six months and fully half out of work for more than two years,  many jobless Americans are feeling a sense of despair and hopelessness not seen since the Great Depression, experts say.

A recently published comprehensive study on long-term unemployed by Rutgers University’s John J.  Heldrich Center for Workforce Development  found that the vast majority of unemployed workers experienced stress in their relationships with family and friends and that at least  11 percent reported seeking  professional help for their depression within the past 12 months. One in two of the respondents in the two-year  national  study  said they began avoiding friends and associates out of a sense of shame and embarrassment – a self-imposed isolation that hurt their ability to network to find work.

Many of these unemployed Americans can’t afford to seek professional  help  because they lost their employer-provided health care insurance when they were laid off.  At the same time, federal, state and local governments have cut back  on spending for mental health clinics and outreach in response to budget crises spawned by the bad economy.

As bleak as things are for many of the unemployed, it could get even worse if Medicaid funding of mental health services is put  on the chopping block this fall, as a congressional “Super Committee” hunts for spending cuts to help reduce the federal budget deficit. Medicaid is the most important source of funding of public mental health services for young people and adults, accounting for nearly half of state mental health budgets, according to the National Alliance on Mental Illness.

This perfect storm  of  rampant emotional problems among the unemployed and the  government’s diminished ability to provide assistance has created “a silent mental health epidemic,” according to Carl Van Horn, a professor of public policy and economics at Rutgers and head of the Heldrich Center.

“Losing a job is more than just a financial crisis for people,” said Van Horn.  “It creates numerous other damage, stress, anxiety, substance abuse, fights and conflicts in the family and feelings of embarrassment and depression.”

Altbier said he had always been the breadwinner in his family, but now his wife’s modest government contract  work, his unemployment checks, and a dwindling savings account are helping the couple keep up with their mortgage and COBRA health care payments with little left over at the end of each month.   Arguments between Altbier and his wife over finances and his joblessness have become commonplace in their suburban Silver Spring, Md., home. He has applied for retail sales associate jobs at places like Best Buy and Sears, but he hasn’t heard back.

“It’s sad, it’s unnerving, and I’m not quite sure how to handle everything,” Altbier said.  “I can’t tell you when and how it’s going to end.”

"I’ve never felt such a feeling of
hopelessness. You think you did
something wrong – it’s my fault.
You’re going to live in a dumpster.”

A 55-year-old former internet technology official for a Washington-area financial service company said he wasn’t worried at first after losing his $200,000-a-year job three years ago because he was confident he could  land a  contract to tide him over until he found another full-time job. But the former official, who would only consent to be identified by his first name, Tom, because of the stigma that society and employers attach to  being unemployed, said he began to panic when the contract fell through, the economy kept flattening, and the competition for the few available jobs became extremely stiff.

“It was very, very bumpy,” he recalled recently. “There were some very depressing periods in there. I’ve never felt such a feeling of hopelessness. You think you did something wrong – it’s my fault. You’re going to live in a dumpster.”

Tom said he spent a lot of time that first fall and winter  alone in his house brooding and watching television . Probably the low point was when his mother asked him, “What did you do wrong?” Finally, he banded together with other unemployed people to compare notes on their lives and develop strategies for seeking work.  Now he’s doing volunteer work while he continues his job search.

The epidemic of depression is  striking even the Washington, D.C. area – which has long been considered recession proof because of the presence of the federal government -- and which has one of the lowest unemployment rates in the country.  Yet Virginia, Maryland, and the District of Columbia cut their mental health budgets by 9.1 percent, 4 percent, and 19 percent, respectively, between 2007 and 2011 according to data from the National Alliance on Mental Health.  That spending decline, coming at the height of the recession, placed a heavy workload on local nonprofits and crisis lines. 

“There’s got to be some investment
not just in job creation, but in dealing
with emotional problems or the
economy could pay the price.”

Tim Jansen, Executive Director of Community Crisis Services, a crisis hotline in Maryland’s Prince George’s County, said that during the past few months  there has been a sharp rise in the volume of calls that he and his 40-person staff have fielded from people experiencing unemployment-fueled  mental breakdowns. His  staff is hearing more and more about people draining their savings and losing their homes after they lost their jobs.   “We used to be able to be more of a cheerleader on the phone for people struggling to get work and buckling under that stress,” Jansen said.  “But the challenges have piled on top of each other over a series of years  and the government’s [role is] fading from view . . . it’s hard to know what to say.”
Extensive research by  the Centers for Disease Control, academic institutions, and  mental health research groups have confirmed a strong correlation  between high unemployment and mental health hospital admissions and suicide.   According to an April CDC study, the U.S. suicide rate has ticked up every time the economy has fallen into recession since the 1929 stock market crash.

A 2009 survey by Mental Health America, a mental health advocacy group, concluded  that the unemployed were four times more likely to report symptoms of mental illness than a working individual.  Mental health problems result from mass layoffs and unemployment, but the longer mental health problems go untreated, the less likely it is that a person can find another job, said  Ronald Kessler, a professor of health care policy at Harvard Medical School and an expert on psychiatric disorders and data. 

“There’s got to be some investment not just in job creation, but in dealing with the emotional problems of people who are waiting around until you can create those jobs—or the economy could pay the price,” he said.

Indeed, that may already be happening.  According to 2008 data collected by Kessler, mental illness costs society roughly $193 billion per year in lost earnings resulting from absenteeism and lost productivity. “But given the current economic crisis, chances are that the true costs are now a bit larger than when we made the estimates,” Kessler said.   The productivity loss will likely grow higher over the next decade as a greater number of people both demand mental health services from a shrinking public mental health system and suffer from untreated mental disorders, he said. 

In the face of an overwhelmed public mental health system, some local nonprofits are stepping in to help rebuild the confidence and drive of the unemployed before they reach their breaking point.  One such group is 40Plus of Greater Washington, an organization that brings together middle-aged professionals who have lost their jobs for job-training, resume-building, and moral support. 

"I’m too young to retire, I’m
ready to work, yet I’m being
treated like I’m over-the-hill."

While the group doesn’t offer mental health services, its weekly meetings are highly therapeutic, providing an outlet for these professionals to bond with each other, network, and focus their career goals.  “All of us have been kicked in the stomach at one time or another,” said the group’s Executive Director, Joel Sarfati.  “If you start out down in the dumps, this gives you an opportunity to sort of reposition yourself.  They meet others in similar situations, develop relationships, go out for lunch, and all of a sudden there’s a place to go and things to do,” he said

Sarfati says the attendance at weekly meetings has quadrupled since he began leading the group three and-a-half years ago, with as many as 60 people attending meetings. 

The organization has helped Tatjana Meerman, a market research professional who was laid off two years ago, to position herself for a career shift from the private sector to  the nonprofit development world working with wildlife and environmental causes.  It’s also helped to mend her wounded  psyche after a grueling year-and-half of job hunting reaped more rejection than she was prepared to handle. 

“Employers told me I was ‘overqualified’ meaning I was too old,” said the 52-year-old Meerman, who lives in Potomac, Md.   “But I’m too young to retire, I’m ready to work, yet I’m being treated like I’m over-the-hill.  That was extremely jarring and very demoralizing, and for a while there, I was definitely skirting depression.”

But discovering 40Plus last May was a game-changer for Meerman, who attends the weekly meetings. She recently  completed the group’s  intensive job-training program, and has landed multiple interviews.  “I’m in a very different place now,” she said. “It’s no longer a matter of ‘if,’ it’s a matter of ‘when,’ and for me I think that landing that ideal job will come in the next three months.”